AccountId: 011433970860
ContactId: d876689b-5ff1-4988-a479-017a67e0a501
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 408839 ms
Total Talk Time (AGENT): 112914 ms
Total Talk Time (CUSTOMER): 105812 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/d876689b-5ff1-4988-a479-017a67e0a501_20250508T14:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from the provider's office checking for the claim denial.
[AGENT][NEUTRAL] OK, I can help you with claim status. [PII]. May I please get your callback number just in case the call is disconnected?
[CUSTOMER][NEUTRAL] Da
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, sir. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yeah, [PII] ID number.
[CUSTOMER][NEUTRAL] [PII] for Mike [PII] for Lima 7.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the date of birth, please?
[CUSTOMER][NEUTRAL] Date of birth, sorry for that, [PII].
[AGENT][POSITIVE] OK, thank you. Let me look that up real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and then may I please get the data of service and the charge amount?
[CUSTOMER][NEUTRAL] Yes, [PII] charge amount for $126 even.
[AGENT][NEUTRAL] And it was [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] And for $136.
[CUSTOMER][NEUTRAL] No, $526 even.
[AGENT][NEUTRAL] 126. OK and then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Yeah, charge amount is $5126 even.
[CUSTOMER][NEUTRAL] The second the amount is $199.
[AGENT][NEUTRAL] Do you have the
[CUSTOMER][NEUTRAL] $88 even.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Yeah, sorry for that which information is required for this one?
[AGENT][NEUTRAL] OK, and then
[AGENT][NEUTRAL] Uh, both the charge amount and then after the primary paid.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] $199.88. The claim was processed towards the deductible amount.
[AGENT][NEUTRAL] OK, and then can you please give me the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Blue radioology Services LLC.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold [PII] while I look up this claim for us and I'll be right back sir.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank thank you [PII] for holding for me. I do have the claim number for you. The claim number is 3,592,790.
[AGENT][NEUTRAL] And the claim was denied because the services were rendered after the termination date of the policy.
[AGENT][NEUTRAL] So the policy was not active, the policy terminated on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Thank you. May I know the effected date?
[AGENT][NEUTRAL] The effective date is [PII].
[CUSTOMER][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] Thank you very much. Could you please provide me that, do you have any other active insurance for this coverage for the loading the data service?
[AGENT][NEUTRAL] No, I did check that and.
[CUSTOMER][NEUTRAL] Do you have that information?
[AGENT][NEUTRAL] Right, I did check that and there are no active policies on file.
[CUSTOMER][NEUTRAL] Thank you very much. And what the last year will be updated date? Do you have any information about that?
[AGENT][NEUTRAL] No, sir.
[CUSTOMER][POSITIVE] Thank you very much we can contact the patient for this one.
[AGENT][NEUTRAL] That is determined by the provider.
[CUSTOMER][NEUTRAL] OK. Do you receive the primary UB?
[AGENT][NEUTRAL] Have you received it?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] May I know the spell your name once?
[AGENT][NEUTRAL] Yes, you could spell my name [PII]
[CUSTOMER][NEUTRAL] Sorry, [PII]
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, may I know the reference number for the call?
[AGENT][NEUTRAL] Yes, you can use my name in today's date.
[CUSTOMER][POSITIVE] Thank you very much. That's it for today. Have a great day. Bye now.
[AGENT][POSITIVE] You have a wonderful day too. Is that everything I can help you with before we go?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you for calling APL you have a wonderful day bye bye sir.
[CUSTOMER][NEUTRAL] Bye bye soon.